A law says what it says, not what the Yes On 26 campaign says on Facebook pages or Youtube videos. Unfortunately, the amendment is so broadly written that, if it has the restrictive effects that Yes On 26 claims, it could also be interpreted by the legislature or the courts to have other negative effects on IVF, such as sharply limiting doctors’ options for specific treatment protocols.

For example, the Yes On 26 campaign claims that Personhood will prevent cryopreserved embryos from being discarded. However, there’s not a single word about embryos in the text of the amendment. Therefore, we must assume that the simple fact of being declared people will implicitly grant these microscopic embryos enough rights not to be deliberately discarded.

If that’s the case, it’s entirely reasonable to ask what other rights those embryos might be granted, and to question how those rights might intersect with other parts of infertility treatment.

The expense and difficulty of IVF is primarily in the creation of embryos. Whenever possible, embryos are saved to use for a subsequent frozen embryo transfer cycle. Embryos are valuable and difficult to create, and reproductive endocrinologists want to give them every opportunity to become babies.

Most couples use all of their embryos while undergoing treatment, and are not left with extra embryos at the conclusion of IVF.

The overwhelming majority of cryopreserved embryos are in short-term storage, and will be thawed and used on a subsequent cycle, or to give a couple a second or third baby in the future. Only a small percentage of the embryo currently in storage belong to couples whose families are complete and who do not plan to ever use them.

Many couples who do have unused embryos at the conclusion of treatment are unable to use them because of health reasons which make it dangerous or impossible for the woman to undergo another pregnancy. Others cannot transfer their remaining embryos because of legal issues such as divorce.

To prevent multiple births, the American Society for Reproductive Medicine recommends that most women should have no more than two embryos transferred at a time. If a couple has more than two viable embryos, the remainder are frozen for use on a subsequent cycle, if the current cycle does not result in a pregnancy.

If doctors cannot freeze embryos, they will be limited to attempting to fertilize no more eggs than they intend to transfer. Unfortunately, there’s no way to know which eggs will fertilize until you actually try to fertilize them, and there’s no way to know which of those fertilized eggs will begin to divide.

If only one or two eggs are retrieved at a time, the overwhelming majority of IVF cycles would result in failure. Most couples cannot afford to pay $12-15,000 per cycle when the success rate would be only around 5%, as opposed to the current rate of around 40%.

Overall, up to 50% of the retrieved eggs will not fertilize, and up to 50% of these microscopic embryos will stop dividing prior to being transferred back into the woman 2-5 days later. Doctors aim to retrieve 8-10 eggs to produce approximately two viable embryos per cycle. However, there’s no way to know in advance how many eggs will fertilize and begin to divide. Those 10 eggs could produce 10 embryos, or none.

Embryo donation for family building is a wonderful idea, but it’s not a universal solution to the problems posed by Personhood. Only a small percentage of couples are comfortable with the idea of submitting their embryos for donation. In those cases, the embryos must either remain in storage indefinitely, at a cost of several hundreds of dollars per year, or eventually be disposed.

If the couple is unable or unwilling to ever use their microscopic embryos to attempt pregnancy, will the government force them to relinquish them? What happens if the couple dies, and passes them to their heirs? Will the option of compassionate transfer (embryo transfer done at a time when pregnancy is virtually impossible) be taken away from the couple?

Conceivably, yes. Cryopreservation has advanced dramatically, but there is still some risk that a microscopic embryo will be damaged or stop developing as a result of the process.

If the Personhood Amendment requires that doctors make every effort to preserve the lives of both mother and baby in the event of even an ectopic pregnancy, where the baby has no chance of survival, it’s reasonable to suppose that freezing embryos would be prohibited as being too dangerous. That would imply that doctors could attempt to fertilize no more than one or two eggs.

A medical procedure which offers no direct medical benefit to a newborn baby, and which carries a 50% risk of killing that baby, would clearly be considered child endangerment. However, if we consider embryos and fetuses to be people whose rights are equivalent to those of a born baby, how could such risks possibly be acceptable in the scenario of freezing an embryo for later usage?

Selective reduction is not performed by any Mississippi doctors, because it’s such a specialized and difficult procedure. Women carrying high-order multiples must already travel out-of-state to have selective reduction performed, usually to Pennsylvania.

Personhood will not stop a single selective reduction procedure from being performed… unless it regulates IVF so strictly that it limits the number of embryos which can be transferred, or eggs retrieved. You can’t simultaneously claim that Personhood won’t affect access to IVF and that it will also prevent selective reduction.

Prohibiting embryo cryopreservation also involves serious risks to the mother’s health. Up to 10% of women who undergo IVF develop a serious complication called Ovarian Hyperstimulation Syndrome, which often requires hospitalization and can be fatal. OHSS is exacerbated by pregnancy, so if a woman develops OHSS, doctors frequently choose to freeze all the embryos. Once she has recovered from OHSS, she can undergo a frozen embryo transfer on a subsequent cycle.

If doctors are forced to transfer all embryos instead of freezing them, women with OHSS will get much sicker in the event of a pregnancy. This is especially true for women who conceive multiple pregnancies, since more babies mean more hormones to make the OHSS more severe.

Multiple birth is one of the less desirable outcomes of IVF. Baby twins are cute, but the health risks of multiple pregnancy are very real. Reproductive endocrinologists are increasingly encouraging younger, healthier women to consider transferring only one embryo per cycle.

Although most women will not have any embryos at all in the limited-retrieval/no-freezing scenario outlined above, younger women will be more likely to find themselves with two or three microscopic embryos, all of which must be transferred. Therefore, they will be at higher risk of having twins or even triplets.

Finally, if IVF is effectively or explicitly banned, infertile couples will be more likely to use procedures such as intrauterine insemination (IUI). IUI carries a higher risk of multiple birth, and especially of high-order multiple birth of triplets or more.

As explained above, most IVF-created embryos stop dividing along the way in the process, despite the best intentions of reproductive endocrinologists. If Personhood advocates oppose the use of hormonal birth control because it can occasionally prevent otherwise-viable embryos from implanting into the uterus, it’s logical to think they might also oppose a process which has such a high embryo loss rate.

Several prominent personhood advocates have expressed exactly this opinion, that IVF is always wrong even when doctors and patients do not deliberately destroy embryos. The Catholic Church, a major supporter of a federal personhood amendment, is also morally opposed to IVF under all circumstances, and even to other forms of infertility treatment which do not involve the potential for embryo disposition.

Over 40% of couples who suffer from infertility treatment have male factor infertility. Men are just as likely to be infertile as women, and couples with male factor more likely to need advanced care like IVF with ICSI. If personhood places heavy regulations on IVF, it disproportionately threatens men who want to become fathers. Of course, men also need pregnancy care options for their wives and unborn children, and for their partners to have access to reliable contraception.

Being childfree is only a choice if you have a full range of options for having children if you want them. We believe that you should choose to be childfree because it’s what’s best for you and your partner, not because of an accident of biology.

According to the Yes on 26 campaign, MS 26 would mean that “every effort be made to save both lives” when an ectopic pregnancy occurs. That might be interpreted by the courts and Legislature to mean that women can’t take medication to end ectopic pregnancies without surgery, or that they can’t have the surgery until a tubal rupture is imminent or occuring. Although the baby has no chance of survival at all, doctors might not even be able to make efforts to save the affected fallopian tube and preserve the woman’s fertility.

The Yes on 26 campaign asserts that they oppose hormonal contraceptives which can prevent implantation. This doesn’t just mean the morning-after pill — it means ALL birth control pills, including the ones currently taken by tens of thousands of Mississippi women. It also means IUDs, including the Mirena IUD (hormonal) and Paragard (non-hormonal).

No form of oral contraceptive is 100% reliable at preventing ovulation, even when taken exactly according to directions. All birth control pills change the lining of the uterus so that, if you happen to ovulate, a fertilized egg is unlikely to implant and develop. Therefore, the passage of MS 26 would mean that women will be unable to use birth control pills or IUDs. Contraceptive choices will be limited to barrier methods such as condoms and diaphragms.

Also, many Mississippi women take hormonal contraceptives to treat menstrual problems such as PCOS and endometriosis. Any measure which might restrict available contraceptive choices threatens these women’s ability to effectively treat their medical conditions.

Misssippi patients can travel to other states to use clinics, particularly those which specialize in treating specific aspects of infertility. Worldwide, many patients whose own countries have restrictive laws also choose to pursue IVF in other countries such as South Africa, Thailand, and India. IVF is very expensive and is almost never covered by insurance in Mississippi; even considering the travel costs, IVF in these other countries is cost-effective.

If doctors could create life all by themselves, IVF would have a 100% success rate. Doctors can put eggs and sperm together, but they can’t force them to fertilize. They can put fertilized eggs into the mother, but they can’t force them to implant and develop into babies. If you are a person of faith, there is plenty of room to see the hand of God at work, guiding the hands of the doctor.

Nor is infertility a sign that someone is not meant to be a parent, any more than a heart attack is a sign that someone is not meant to be alive. It’s a physical disease, which affects men as often as woman, and strikes couples of all ages. It deserves the same treatment as any other illness.

Adoption can be a great way to build a family, but it has complicated issues of its own. It can be just as expensive as infertility treatment, and can involve as much uncertainty and heartbreak. It can be a long and invasive process.

Infertile couples are no different than than any other people who want to have a biological family. They happen to have a physical disease that makes it more difficult for them to do so, but that alone is not enough to make all of them want to become adoptive parents, any more than diabetes or heart disease would be.

If you support adoption, encourage it for all families, regardless of how well their reproductive systems function. People should adopt because they truly want to be adoptive parents, not as a last resort.

You can be pro-life and still believe that MS 26 is much too restrictive. Many IVF patients consider themselves pro-life, and ALL patients are counseled about the ethical issues prior to undergoing treatment. Couples who are considering infertility treatment put extensive thought into their choices, as do their doctors.

MS 26 is about so much more than just abortion. Even if you’re strongly opposed to elective abortion, please consider that a Yes vote is also a vote against IVF, birth control pills, and safe ectopic pregnancy treatment.